Debit Order Quote

Personal Information

Name*

First Last

Contact Number*

Email Address*

Business Information

Company*

Website

We prefer working with businesses who provide a website.

Is your business in the call centre industry?*

Do you sell holiday vouchers or run rewards / loyalty programs etc?

Call centres must ensure they are able to comply with the following requirements:

Copies of Company Documents
Proof of Business Premises
Copies of Identity Documents for all Directors/Members
Proof of residence for all Directors/Members
Confirmation of membership with the Direct Marketing Association (DMA)
Business plan
List of the products being sold
All terms and conditions of use relating to the product/s sold
Please indicate whether you are the owner of the products being sold
If you are not the product owner and are purchasing the products and reselling, contracts to support the authority to sell these products will need to be provided
Please indicate whether a paper/voice mandate is used or both
If a paper mandate is used, a copy will need to be provided
A copy of the document that will be sent to all clients within 21 days of a successful sale
If voice mandates are used, the minimum requirements need to be adhered to, and we require sample voice recordings to verify this
Proof of capability to retain voice mandates for 5 years
Complaints policy
Cancellation policy
Site visit from a Direct Debit representative
Indicate how leads are generated? If information is being bought, a copy/extract is to be provided
If an existing debit order service provider is being used the following will apply:
- Please indicate unpaid ratio
- Last 3 months reports reflecting transactional history  i.e. Number of successful transactions, unpaid transactions, transactions disputed

Enterprise Number

Address*

Address Address Line 2 City Province Postal Code Country

Requirements

Do you currently make use of debit orders?*

Yes
No

Services*

EFT Debit (Debit order collections)
EFT Credit (Payments)
NAEDO (Debit orders with credit tracking)
AC (DebiCheck debit orders)
AEDO (Chip and pin card solution)
AHV or AVS (Verify bank account holder)
Billing System
Payment System
Unsure (Please help me select)

Which services do you require?

Tracking Days

Transaction Volume*

How many clients do you currently debit?

Estimated Volume

How many clients do you plan to debit?

Transaction Value (R)*

Specify total monthly debit amount in Rand.

Estimated Value (R)

Specify total monthly debit amount in Rand.

Line/Item Limit (R)*

Specify your desired line/item limit in Rand.

Success Rate (%)

Dispute Rate (%)

Additional Requirements

Do you have any additional requirements or queries?

Terms and Conditions

Signature

If your device does not support this feature then you may proceed without signing.

I agree by electronic signature of this document that the information I have provided via this form on 18/04/2024 is valid and correct to the best of my knowledge. I also understand that my computer address has been recorded as 39.165.103.115 and that this may be used to locate and identify me in the case of a fraudulent declaration.

Comments

This field is for validation purposes and should be left unchanged.

Get a Quote

Personal Information

Business Information

Requirements

Terms and Conditions